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I have a bone to pick with expectations. I first learnt about them on a student exchange trip to France at the age of 17. It was meant to be “amazing”, a “once in a lifetime experience”. Instead it was lonely and difficult. I found myself in a world where I could not express myself and as a result became an outsider, that awkward person that hangs on to groups of people without contributing. I became depressed and felt guilty for squandering this “amazing” experience with my own genuine feelings. I was so disappointed and let down by my experience and felt the blame lay squarely on my unrealistic expectations. This spurred a realisation for me. Expectations can ruin an experience. Not once in the lead-up to my 2 months abroad did anyone say to me: “you’ll feel really lost”. Instead it was “you’ll find yourself”. Well, I found more of my physical self as I made a daily trip to the patisserie to fill my emotional void with sugar coated almond croissants. But unfortunately, I had never felt more insignificant.  Yum! Image by Faruk Ates Looking back, I still think it was a valuable experience, but it should have been just that…an experience, not “the time of my life”. I think that actually goes for most major events in life. I had a similar experience following the birth of my first child, Lily. The most common question I was asked during my pregnancy was: “Are you excited?” After hearing this for the 20th time, my response was reactionary and immediate, I would break out the big smile, nod profusely and explain I couldn’t wait. And it was the truth. But the effect of this question was like hypnosis for me. It solidified my subconscious thinking that parenthood was meant to be, and going to be ‘exciting’. Even if I may have read a chapter on settling, or listened to the antenatal session on juggling time in the post-natal period, these concepts were abstract and hard to tangibly imagine. The overwhelming emphasis from my world was that this was going to be the most exciting and rewarding journey of my life. Then, diagnosed with post-natal depression when Lily was 6 months old, I was perplexed. This was meant to be exciting and rewarding. Why was I finding it so difficult? How is it, that millions of women have done this mothering caper the world over, and I feel it is beating me? I was young, healthy, fit, and educated. I had read the books and attended the classes. At my kinder graduation aged 5, my teacher proudly announced I wanted to be a mum when I grew up. BRING IT ON!! The reality…you all know it, turn on the broken record. Tired beyond all scope of possible imaginings, feelings of defeatism as a tiny person up-ends your life and makes you feel inadequate, body changing issues, a feeling of distance with your partner, watching your friends go overseas and earn money and attend trendy wine tasting events. I was expecting this:  But I was experiencing this:  Image: shoeboxblog.com I thought there was something wrong with me. Now I know, there wasn’t. My expectations were just so far from reality that I had lost before I had even begun. I tried to keep up the performance of being on top of everything and “happy”. It was EXHAUSTING. But why did I do it? I’m still not entirely sure. Maybe because I didn’t want to let down everyone who was telling me how happy I should be. Maybe because people don’t want to visit you when your a vomit-stained, un-washed, teary mess who keeps falling asleep. Maybe because I thought I’d fool myself if I kept on the hamster wheel. Did it work? Yeah, maybe. Sort of. Not really. What did work? Talking. Well for me anyway. Mothers’ group was brilliant. 8 other mum’s right there in the trenches with me, sleep deprived, angry at our husbands, feeling like slaves to our 6 months olds. It was gold. We used to open a bottle of wine at 12.30PM and get it all off our chests. Then I had to talk to a psychologist for a bit as well. Similar issues, less wine and more expensive; but also very helpful. Should 1 in 7 mums experience post-natal depression? It seems wrong to me. So, I find myself asking, what are we doing as a culture, as a society that makes this feeling of defeatism and sadness so profoundly common in new mums? Unrealistic expectations are playing their part. Unrealistic expectations of happiness, of fulfilment, of love, of connection with your partner, of physical recovery. And unrealistic expectations and understanding of the enormity and loneliness of the mother workload. So, as a community can we moderate this expectation? I think we can. It’s not about bringing all pregnant women down and telling them depressing stories about motherhood. But let’s just say it how it is. There are high’s and there are low’s. Let’s ask open ended questions to pregnant or new mums such as “How are you feeling about becoming a mum?” to allow them to express themselves, rather than ramming pre-packaged emotions into their psyche. None of this is to say it’s not worth it. And for goodness sake, share your lovely stories about your children too. But don’t sugar coat parenthood. Don’t watch too many nappy ads that make being a mother look like running through an immaculate house in white pants while your perfectly clean child giggles constantly. Sure, there is the odd moment like that (FYI: you’re mad if you wear white anything as a mum, and my house has never been immaculate since becoming a parent) but the bare bottomed giggles and the cuddles do happen, and are awesome! As a community and society, let’s help to put expecting parents in a frame of mind that acknowledges the road into parenthood not as “the time of your life” but for what it is, an experience. 
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 Do you wee more than every 2 hours? Do you wake up overnight to wee? Do you make sure you go to the toilet before you leave the house? Do you rush to the toilet as soon as you get in the door?
If you answered yes to any of the above questions, you are not using your bladder correctly, and you could be setting yourself up for conditions such as:
The bladder’s job is to fill, store and then empty urine. The bladder is a muscle, called the detrusor muscle. Which means it’s really good at stretching, then forcefully contracting and rebounding to it’s normal shape. And it does this over and over and over, every day of our lives. Within the wall of the bladder, there are baroreceptors, or ‘pressure receptors’ that feedback information to our brain about how the bladder is filling. Once these messages get loud enough, they come to our conscious attention, and we get the urge to go to the toilet. Once on the toilet, our brain sends a message to the bladder to contract, and the bladder muscle squeezes all our urine out. Sounds simple right? And it can be. But the bladder muscle, like every muscle in our body, contracts best within a certain range of motion. Or, in the case of the bladder, within a certain volume of urine. So, why do we care if our bladder is, or isn’t contracting at it’s best? If the bladder is not filled enough, then the detrusor muscle is unable to generate sufficient force to expel all the urine, and we can experience; poor urine flow, increased post-void residual (the amount of urine left in the bladder after emptying), urinary frequency, and increased risk of urinary tract infections. Additionally, over time, if the bladder is never allowed to fill up and stretch, the detrusor muscle becomes stiff and can become unable to hold decent urine volumes. This can progress to symptoms such as urinary urgency, urinary frequency, nocturia (waking more than once per night to urinate), and urinary urge incontinence. Now, don’t get too carried away on the big wee’s, bigger is not always better. If you repeatedly over-stretch your bladder muscle, you end up with lazy pressure receptors that forget to send your brain the message that your bladder is filling. Also, your bladder ends up looking like a deflated balloon and this also can result in poor urine flow, poor emptying and urinary urgency. So, hopefully now you are asking “What is this magic volume that I need to be wee-ing at every toilet stop?” Drum roll please…..Optimal bladder habits are as follows: 250-500mls per wee 5-6 wee’s per day 0-1 wee per night. So, how do you find out if this is what you are doing? Grab yourself a measuring device (preferably a dedicated one you have purchased for the task, and not the kitchen measuring cup), measure and write down your wee’s for at least a 24hour period. If you fall within the above range, give yourself a pat on the back (or bladder) and move on. If not, make the time to speak to a continence professional such as a urologist, continence physiotherapist or continence nurse and find out what is causing your less than optimal bladder habits, and how to fix them. Unfortunately, we know that poor bladder habits or urinary symptoms such as urgency, frequency and incontinence get worse over time unless they are treated. So seek treatment sooner rather than later.  She came from my being. Started as a seed, always there. Never apart. Her number was chosen, she won and thrived; My bread was her bread, my lungs, her air. She was me. There was no divide. My rhythm was her lullaby. We became an alien, a two headed, strong willed force of nature. She came with a purpose, perfect from the start. She breathed her own oxygen and her blood pumped red. I didn’t think twice when they cut her physical bond to me. It didn’t even bleed a tear. We smiled. Why didn’t I mourn that more?  She did not recognise herself, rather knew herself only in relation to me. Without my body, my scent, my sounds; she was lost. My milk sustained and nourished her. She grew fat on it. She was physically, completely a product of my body. I was her world. It came with responsibilities; some of which were terrifically, physically, emotionally challenging. Others that were utter gluttony in their delight. And all she wanted was me, we were so wrapped in each other, We may as well have been one and the same. And we were.  She took food from a spoon and I mourned a little loss, Gone was the monopoly I had on her creation. She carried on the job of children; to grow and learn and become. Become a personality, an individual, an identity, a person. She found her voice, a beautiful husky utterance that I recognised as my own. We watched her stumble out her first steps and babble out her first words. Steps became skips and words became songs. She was blooming. And so was our love.  And all this time, she had been observing, Drinking in language, gestures, concepts. Lapping up information and gathering opinions. Lots of them mine, but then, a word I do not say, or a gesture that is foreign. There is a dart of panic. A loss of control. An extension of the cord Now she is at school. Now the tables have turned. I am here for food, for clothes, for transport, for sleep. But there are many hours and many teachers and many friends, shaping my baby. This walking, talking, running, jumping, skipping, thinking, writing, reading; baby of my body.  Then there are the moments before dawn, a little tip toe down the hall
There is a soft little voice and hand and she is curled in my body once again. Later, she will make her breakfast, dress herself, and run with friends But in this moment, rarer by the day, she has come home to rest. She is beautiful and she is mine. But when did she become apart from me? I will never know. And I will not hold her back. Though she may travel far and wide, She is my baby of my body, and always she will be. “But if my muscle is tight, why am I still leaking?” This is a great question. And the best way to answer it is to imagine we are talking about a different group of muscles in your body, such as your neck muscles.  Most people will have experienced a sore and painful neck at some point in their life. And when you’ve had that sore neck, it’s often hard to turn your head, or you do so with trepidation, much more slowly than usual. Well, I bet during this uncomfortable time, you’ve also reached up to rub your sore neck and possibly touched the major muscle groups that are responsible for these neck movements. Did you ever notice how tight and hard they seemed under your fingertips? So, we have a sore neck, we have tight muscles and we have loss of function. This is exactly what is happening in your pelvic floor.  Most often, something will have occurred in the pelvis to cause your pelvic floor muscles to became overactive and tight. This incident may have been, for example: a painful experience with constipation, a history of recurrent urinary tract infections or thrush, or an uncomfortable sexual experience. As a result, sometimes the pelvic floor muscles will go into spasm, or the individual may begin holding tension in the pelvic floor muscles as a way of subconsciously providing protection to the area. This causes the muscles to become short and stiffened. When muscles are held in a shortened position, they have less ability to contract and perform their function in a responsive and timely manner. If we go back to the example of our neck; turning your head (which is the function of the neck muscles), may be reduced, and will be performed more slowly in the presence of tight, stiff neck muscles. In the case of the pelvic floor, the ability to engage and contract to support the bladder and occlude the urethra (which is the function of the pelvic floor), will also be reduced, and will be performed more slowly when the muscles are tight and stiff, and this will lead to urinary leakage.  So, if this is the case, asking this woman to do lots of pelvic floor exercises focused on squeezing and holding is not going to improve her urinary leaking. In fact, it may make it worse, or give her a new condition due to even more spasming in her pelvic floor muscles.
Instead, what will assist this woman is if she can learn to downtrain the muscle tension. This can be taught and practiced and once we have a healthy muscle, sitting at a good resting length, we can then teach appropriate functional recruitment of the pelvic floor which will lead to long lasting continence.  I’m pretty much what you’d call a type ‘A’ personality. There’s a part of me that is, or used to be secretly proud of this statement. Doesn’t type ‘A’ mean you’re a perfectionist? That you work hard and achieve high? Well, maybe, but only if the conditions are perfect, and it’s likely that if you really are a type ‘A’ nothing will undo you’re perfect world faster than welcoming a little person or two into your life.
Type A’s like to have their ducks in a row, a very neat row. Generally, their brainwaves run at a pretty high velocity, often jumping on different thought trains and travelling fast in all sorts of directions. Sometimes helpful ones that solve problems quickly and get things done efficiently, especially if you can focus your full attention and can mobilise yourself to that task in that moment. But what happens when you are forced to slow down? When you cannot get off the couch because your 2 month old has decided they’ll only settle whilst on your chest but you know you need to get to the shops to make that dinner you had planned. Or when you cannot sit in front of the computer for 30mins to type that important email because you’ve just picked up the kids and they are hungry, need afternoon tea NOW, and need to tell you about a fight they had with a friend? What happens inside that type A mind? Does it accept this new state of incapacity? Of delay? Of imperfection? Or does it run faster? Does it try to do both things at once? The truth is being a parent sometimes (often) involves doing things well below your maximum brain power. So, it makes sense to do something else at the same time. Doesn’t it? I think about what I need at the shops while acting like I don’t know how to do a 9 piece puzzle with my 4 year old; I think about work and formulate a ‘to-do’ list while putting together a nutritionally balanced, interesting and hopefully palatable lunch box. I thought this was multitasking and patted myself on the back for proving to the invisible Gods that women can indeed do two things at once. However, as we learnt from last weeks blog, it’s not multitasking at all but instead a horrible state of mind called ‘Continuous Partial Attention’ which forces you into a constant state of adrenal attention and eventual chronic stress and has serious health impacts. For more on this, check out last week’s blog here. After years of doing this, I started to feel vague and disconnected. Like I wasn’t properly seeing or focusing on things. But more than that, it’s hard to describe…a sort of brain fog, a desensitisation, like an imposter was walking around in my life and they were doing a really bad acting job. It actually felt awful. Sometimes my days were passing, but I wasn’t noticing or enjoying them. And the odd thing was, I wasn’t being that effective, even though that was the whole point of multitasking in the first place. I’d start five different tasks, but not finish one. I’d think about abizzilion thoughts, but none of them would end anywhere useful or decisive. And all this while I was missing chunks of my day that left me feeling a bit powerless and lost. Then, I started hearing about the mindfulness movement, about being present, about immersing yourself in the sensations, the feelings and the thoughts of the present moment to achieve a calm and focused mental state. Yes! I thought. This is me…This is what I’ve been missing. I’ve been mentally somewhere else because I was trying so hard to be everywhere and be everything. I want to feel present all the time, I want to really see my kids when I look at them and hear their little voices. Not be caught up in some other task my brain is wanting to focus on. But it’s hard to do. The shopping list still needs to be thought about and doing the same 9 piece puzzle every day is mind numbingly easy. So how do we do it?! How do we genuinely engage in our present and not be temped into the easy trap of mentally drifting away? Well the first is to convince your brain that it’s not worth it. That doing several things at once does not in fact make you any more efficient. This may take some time because you’re brain is pretty stubborn, so you need to be patient, kind to yourself and persevere. Then, there are some pretty nifty Mindfulness tools you can use to bring your mind back to the moment. Here are some of my favourites: “One thing at a time.” When I feel my mind racing off in front of me, I rein it in by repeating “One thing at a time” to myself. It’s a great mantra and immediately forces me to be calm, methodical and see what is in front of me. Notice the small things. When my 4 year old is concentrating on a puzzle, she gets an adorable focused look on her face. I can see her brain ticking and her entire body is involved in locating the pieces, fitting them into place with her pudgy little fingers and then she gives herself an adorable clap when she’s done. When I focus on these details my mind is sharper, and alive. I feel happy that I’ve genuinely enjoyed watching this little piece of magic. Feel sensations on your skin If you are outside, become aware of the sun on your skin, or a cool breeze. If you are feeling warm and cosy or wearing something soft, take a few seconds to acknowledge the material sitting on your skin. Even better, if you are lucky enough to be holding a little persons hand, notice how soft it is, yet how much power they have to cling tight to you. Take a belly breath Breathing a full breath and travelling with the air into your nose, down your throat, into your lungs and through your blood and to your muscles is a great way of becoming aware of your body in the present. It also, floods your system with oxygen which rejuvenates your cells and gives your more energy. This is a good start. But it’s not an immediate fix. One thing I’ve learnt is that you need to forgive yourself. It’s helpful to treat your mind like you would a 2 year old. Steer it in the right direction, but when it starts playing up, gently, and with good humour, direct it back on task and don’t expect too much of it. Mindfulness, it’s a journey worth taking. Not one I profess to be much good at yet, but I really have no interest in continuing down the unfulfilling journey of poorly attempting to multitask, and I encourage you to do the same. |
Welcome!Hi! Welcome to The Blog! Please be aware, Womankind Physiotherapy's blog is not intended to replace information and advice from your health care provider. For specific concerns regarding your health you must seek individualised care by your preferred provider.
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